Cannulated cancellous screws versus dynamic hip screw in femoral neck fractures: a comparison in productive age group at tertiary care hospital of North India
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20205398Keywords:
CCS vs. DHS, Fracture NOF, Tertiary care hospital, North IndiaAbstract
Background: Since intracapsular fracture neck femur was recognized by Ambrose Pare almost 4 centuries back, the management of intracapsular neck femur fracture has undergone many changes. The multitude of various implants designed and techniques available for its treatment themselves indicate the inadequacy of the various methods of treatment. Objective was to compare cannulated cancellous screws (CCS) versus dynamic hip screw (DHS) in femoral neck fractures in productive age group.
Methods: This observational study with both prospective and retrospective data analysis of patients operated by different surgeons in same hospital setup has been conducted from March, 2018 to February, 2020 at the department of Orthopedics, Government Medical College (GMC), Jammu. 105 cases satisfying the inclusion criteria admitted in GMC Jammu were included clinically and radiologically. Total number of patients included in the study was 97 patients as 8 patients were lost to follow-up. Functional outcome was evaluated by using Harris hip scoring.
Results: In our study 8 CCS cases were lost to follow up. Total 97 of cases were followed up till one year both radiologically and clinically after a given time intervals and final assessment done on the basis of Harris hip score. Among 97 cases 71 were males most of them in age group of 41-45 years and 26 were females with 46-50 years age group predominance. 47.42% fractures were classified as type III in garden’s staging.
Conclusions: DHS is a better implant than CCS in hands of doctors who lack of expertise and precision i.e. required for CCS in fracture neck femur in young adult patients.
References
Dickson, James A. The unsolved fracture. J Bone Joint Surg. 1953;4:805-22.
Garden RS. Low-angle fixation in fractures of the femoral neck. J Bone Joint Surg. 1961;43B:647-63.
Luice RS, Fuller, Stephen, Burdick DC, Johnston RM. Early prediction of avascular necrosis of the femoral head following femoral neck fractures. Clinic Orthopaed. 1981;16:207-14.
Parker MJ, Banajee A. Surgical approaches and ancillary techniques for internal fixation of intracapsular proximal femoral fractures. Cochrane Database Syst Rev. 2005;18:2.
Asnis SE, Wanek-Sgaglione L. Intracapsular fractures of the femoral neck. Results of cannulated screw fixation. J Bone Joint Surg Am. 1994;76:1793-803.
Swiontkowski MF. Intracapsular fractures of the hip. J Bone Joint Surg Am. 1994;76:129-38.
Tronzo RG. Symposium on fractures of the hip. Special considerations in management. Orthop Clin North Am. 1974;5:571-83.
Lakhani AA, Mahajan N, Sonawane DV. A Comparative Study of the Management Of Fracture Neck Femur By Dynamic Hip Compression Screw With Derotation Screw Versus Three Cancellous Screws. J Medic Thes. 2014;2:5-8.
Singh M, Sonkar D, Verma R, Shukla J, Gaur S. Comparison of the functional outcome of DHS versus CCS in Pauwels type II and III fracture neck femur in young adults. Int J Orthoped Sci. 2017;3:745-9.
Sharma A, Sethi A, Sharma S. Treatment of stable intertrochanteric fractures of the femur with proximal femoral nail versus dynamic hip screw. Revista Brasileria de Ortopedia. 2017;53:1016.